Changes in sensation following a brain injury can have a huge impact on function. For this reason, sensation must be thoroughly assessed both through observing movement and often also at the detailed impairment level. That way, if we fully understand what is going on, we can look to addressing the problem and retraining the movement.
What is the somatosensory system?
The somatosensory system works to interpret bodily sensation in all its different forms including touch, pressure, vibration, temperature, itch, tickle or pain. The somatosensory cortex is responsible for processing and integrating sensory information and is located in 1 of the 4 major lobes of the cerebral cortex: the parietal lobe.
Highly specialised sensory receptors on the surface of the skin and in muscles are innervated by stimuli which then send a message to the somatosensory cortex to interpret and process in order for your muscles and body to react accordingly. An injury to this area of the brain or to the sensory pathway from a stroke, a traumatic brain injury or a progressive condition such as multiple sclerosis can cause disruption to process and therefore result in disturbances in your sensation.
What can help?
Specialist identification techniques to distinguish the kind of sensation loss and the area which has been affected is hugely important. We can then establish the role this loss plays with the affect on movement and function.
Exposure to specifically designed individualised training tasks which:
a. stimulate neurogenesis – creating new neurons and the pathways between neurons
b. enhance existing neuroconnection
Repetition is vital to establish and strength connections. Repetition of the task is required for neurogenesis and neuroplasticity to occur and to consolidate learning. We need to expose our neurological system to thousnads of reps a day!
a. Visual, auditory and sensory feedback is required for skill learning
b. The non-affected side can be used as a “calibration” measure to assist with this feedback system and to help signal input comparing the “normal” sensation with the altered sensation
a. Once certain tasks are achieved it is important to reassess and progress to more complex tasks
b. Neural systems are enhanced when it is constantly challenged with novel tasks
c. As you progress these tasks will be transferred in skills required in everyday life
So, are you including enough sensory training into your rehabilitation program?